Rheumatoid Arthritis

Detection of early joint disease and monitoring the disease activity in established disease

Rheumatoid arthritis is a chronic inflammatory disease  affecting around 1% of the population.

The cardinal symptom of the disease is affection by swelling and pain from especially the joints of the hands and feet.

Fast disease control and monitoring is essential as active disease can cause damage, disability and decreased quality of life for the patient.

Ultrasound examination of the joints has been shown to be a sensitive and specific method for both detecting signs of early disease and evaluate arthritis
activity in established disease.

The use of ultrasound in scoring of arthritis activity has been standardized.

The disease activity score is found by performing both using B-mode and the power doppler ultrasound-
settings when performing the scanning of the joints synovium. Different scoring systems have been developed  (see picture for example).

We use the EULAR-OMERACT scoring system where a synovitis score from 0-3 can be found by combining score of B-mode and power doppler scanning (1).

A central problem is that ultrasound scanning is operator dependent with a moderate to good interobserver reliability. This variability in scanning results can potentially aff ect the monitoring of disease progression.

We want to develop a platform for automated ultrasound scanning followed by automated interpretation of disease activity by a neural network in the system. All scanning results are saved in the systems and can be reviewed by the doctor.

The system is to be used for both detection of  early joint disease and help the doctor in monitoring the disease activity of patients with established disease.

 

1) Terslev L, Naredo E, Aegerter P, Wakefield RJ, Backhaus M, Balint P, et al. Scoring ultrasound synovitis in rheumatoid arthritis: a EULAR-OMERACT ultrasound taskforce-Part 2: reliability and application to multiple joints of a standardised consensus-based scoring system. RMD Open. 2017;3(1):